Nicholas D. Kristof | Killing Them Softly

NAIROBI, Kenya - In fairness to President Bush, he presumably meant well when he cut off funds for some of the world's most vulnerable women.

The Bush administration announced a few weeks ago that it was halting payments to the Reproductive Health for Refugees Consortium because, it said, one of the seven charities in the consortium was linked to abortions in China. So I decided to do what the White House didn't come out and see these programs we are slashing.

That's where I met Rose Wanjera, a 26-year-old woman with one small child and another due about November (she isn't sure because she hasn't had any prenatal care). This month her husband was mauled to death by wild dogs, and she developed an infection that threatens her health and the unborn baby's.

She turned to a clinic affiliated with Marie Stopes International, where a doctor treated her infection, palpated her bulging stomach and enrolled her in a safe-motherhood program. Unfortunately, this is the very aid group that the White House is campaigning against for supposedly being involved in abortions in China. Even before the latest cuts for aid to refugees, the Kenyan program of Marie Stopes International had already had to close two clinics and lay off 80 doctors and nurses because the Bush administration had applied its "gag rule" (no money to groups that mention abortions) and cut off grants for it.

So because of White House maneuvering, girls and women in Africa's shantytowns are losing programs that offer them prenatal checkups, well-baby care, childbirth and family-planning assistance, and, above all, help fighting AIDS.

Consider Deka Hamid, a 25-year-old Somali refugee who brought her 5-month-old son to a Marie Stopes clinic because he is too weak to hold his head up. Doctors offered some treatment, but there may be no cure because the health problem arose from a flawed delivery by an untrained Somali midwife.

Complications of pregnancy and childbirth kill a quarter-million African women each year, and those deaths are what the refugee consortium is trying to prevent. I visited five Marie Stopes clinics in Kenya, spoke to the patients and front-line doctors, and found them to be a lifeline for destitute girls and women who have few alternatives.

At one clinic, doctors fought to save the unborn baby of Gladys Wambui, an impoverished 27-year-old woman who was close to her due date but whose fetus had abruptly stopped moving. Ultimately, she lost the baby.

It was horribly discouraging, as work here in the slums often is. The doctors and nurses in these clinics are fighting AIDS, rape, sexually transmitted diseases and genital mutilation of girls, and instead of being hailed as heroes, they're denigrated and stripped of funds by White House ideologues who don't know what an African slum is.

Because of the cutoff of U.S. funds to the refugee consortium, the head of Marie Stopes in Kenya, Cyprian Awiti, says he is having to drop a planned outreach program to help Somali and Rwandan refugees.

"Bush does not realize how many people are going to suffer," Mr. Awiti said. "If you don't give money to the consortium, does he know how many deaths he will cause?"

U.S. officials acknowledge that the refugee consortium (which also includes CARE and the International Rescue Committee) does great work. But they said this was outweighed by Marie Stopes's activity in China.

It's true that Marie Stopes International operates in China providing contraceptives that reduce the number of abortions there. If Mr. Bush were trying to do something about coercive family planning in China by denouncing such abuses, I'd applaud him. But instead he's launching his administration on an ideological war against groups like the U.N. Population Fund and Marie Stopes. In fact, these groups are engaging China in just the way the White House recommends most of the time.

When the topic of human rights abuses in China is raised, Mr. Bush usually argues, wisely, that it would be wrong to impose sanctions that punish the Chinese people. So it seems odd that when the issue is Chinese family-planning abuses, Mr. Bush responds by punishing African women.

Mr. Bush probably sees his policy in terms of abortion or sex, or as a matter of placating his political base. But here in the shantytowns of Africa, the policy calculation seems simpler: women and girls will die.